Download Understanding radiation therapy

Understanding
radiation therapy
A guide for patients
their families and friends.
Treatment
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Disclaimer: The information enclosed is provided for educational purposes or for personal use only. Cancer Council
Queensland (CCQ) strongly advises this information should not be used as a substitute for seeking medical or health
care advice. We strongly recommend that you seek advice from your doctor or treating health care team before
making any decision about your health care treatment. Please note that the information enclosed reflects the opinion
of the author/s at the time of writing. Every effort has been made by CCQ to ensure its accuracy, however CCQ and
its advisors do not accept any liability in relation to this information. This publication is current as at March 2011.
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Introduction
This booklet is designed to help you understand more about
radiation therapy. People affected by cancer often report that seeking
information about cancer and treatment options assists them to
feel more in control and prepared for what is happening. However
people have different needs for information, different levels they are
comfortable with, and their information needs change over time.
Your capacity to absorb information can also be affected by a
stressful event such as the diagnosis of cancer. With this in mind, we
recommend that you approach this booklet with an open mind. Read
what is relevant to you and take your time to absorb the content. You
may find it helpful to read this booklet in small sections and skip over
those that do not interest you at this stage. You may also find you
want more detailed information than this booklet provides.
The information provided in this booklet may be helpful in deciding
what questions to ask the doctor and nurses involved in your care.
This booklet is not designed to replace information provided by your
treating doctor or health care team. We encourage you to talk with your
doctor or health team about the questions and concerns you have.
For further information, please feel free to call the Cancer Council
Helpline on 13 11 20, Monday to Friday, between 8am and 6pm.
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Personal information
Ask your doctor or nurse to help you complete this page
Name
Doctor’s name
PhoneA/H
Hospital
Hospital contact person /
cancer co-ordinator
PhoneA/H
Specialist
Phone
Nurse
Phone
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Contents
01 .......... What is cancer?
03 .......... What is radiation therapy?
03 ...... Where do you have your treatment?
04 .......... How does radiation therapy work?
04 ...... Why is radiation therapy used to treat cancer?
05 .......... How is radiation therapy given?
06 .......... External radiation
07 ...... Your first visit
08 .......... What is planning?
09 ...... What technologies are available?
10 ...... How long is the course of treatment?
10 ...... Will the treatment be painful?
11 ...... Will I be radioactive?
13 .......... Internal radiation
14 ...... Brachytherapy
16 .......... Radioisotope therapy
18 .......... Side effects from treatment
19 ...... What can I do about fatigue?
20 ...... Skin problems
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23 .......... Getting to and from treatments
24 .......... Check-ups and follow-up care
27 .......... Coping with cancer
30 .......... Talking to your doctor
32 .......... How will treatment affect me emotionally?
34 .......... Ways to help yourself
37 .......... About clinical trialss
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What is cancer?
Cancer is a disease of the body’s cells, which
are the body’s basic building blocks. Our bodies
constantly make new cells: to help us to grow,
to replace worn-out cells, or to heal damaged
cells after an injury.
Normally, cells grow and multiply in an orderly way, but sometimes
something goes wrong with this process and cells grow in an
uncontrolled way. This uncontrolled growth may develop into
a lump called a tumour.
A tumour can be benign (not cancer) or malignant (cancer). A benign
tumour does not spread outside its normal boundary to other parts of
the body. However, if a benign tumour continues to grow at the
original site, it can cause a problem by pressing on nearby organs.
The beginnings of cancer
Normal cells
Abnormal cells
Abnormal cells
multiply
Malignant or
invasive cancer
Boundary
Lymph vessel
Blood vessel
Some benign tumours are precancerous and may progress to cancer if left untreated.
Other benign tumours do not develop into cancer
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A malignant tumour is made up of cancer cells. When it first
develops, this malignant tumour may not have invaded nearby
tissue. This is known as a cancer in-situ (or carcinoma in-situ).
As the tumour grows, it invades surrounding tissue becoming
invasive cancer. An invasive cancer that has not spread to other
parts of the body is called primary cancer.
Sometimes cells move away from the original (primary) cancer and
invade other organs and bones. When these cells reach a new site,
they may continue to grow and form another tumour at that site.
This is called a secondary cancer or metastasis.
How cancer spreads
Primary cancer
Local invasion
Angiogenesis —
tumours grow their
own blood vessels
Lymph vessel
Boundary
Metastasis — cells
move away from the
primary tumour and
invade other parts of
the body via blood
vessels and lymph
vessels
Blood vessel
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What is radiation therapy?
Radiation therapy, sometimes called
radiotherapy or x-ray therapy, is the use of
controlled high-energy radiation such as x-rays
to destroy cancer cells and stop them from
growing and multiplying.
There are different types of radiation therapy. The type of radiation
therapy depends on the individual patient and the type of cancer.
Radiation oncology refers to the medical speciality of treating cancer
by radiation. The doctor treating you is called a radiation oncologist.
Where do you have your treatment?
Radiation therapy requires expertise, specially trained staff and a
great deal of technological support. This is why radiation therapy
departments are generally located in larger regional hospitals.
Radiation therapy departments are run in different ways, and their
operations may vary slightly from region to region. While most of the
general information in this book will apply to most departments, you
may find things are done a little differently at the treatment centre you
attend.
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How does radiation therapy work?
Radiation therapy is a targeted treatment that,
in sufficient doses, kills cancer cells in the area
of the body being treated.
The normal cells in the treated areas will also be affected, but they
are able to repair the damage caused by radiation. For this reason
treatments are carefully planned, ensuring the cancer receives an
adequate dose of radiation whilst causing as little damage as possible
to normal cells.
Why is radiation therapy used to treat cancer?
Radiation therapy can be used to:
•Cure cancer. For certain kinds of cancer, radiation
alone or radiation as the major modality of treatment is
enough to destroy the cancer;
•Assist other treatments. Often radiation therapy
is used with other treatments such as surgery or
chemotherapy. This is known as adjuvant radiation
therapy. It is used to make the main treatment, for
example surgery, more effective;
•Relieve symptoms. Radiation therapy can be used to
relieve pain or other symptoms, such as bleeding, by
shrinking the cancer and slowing its growth.
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How is radiation therapy given?
Due to improved technology and knowledge
about how radiation therapy affects cancer, it
has developed into a very versatile treatment.
It is used to treat a variety of cancers including breast, prostate,
lung, bowel, head and neck, bone, brain and skin cancers.
There are two main types of radiation therapy:
1) External radiation; and
2) Internal radiation.
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External radiation
External radiation is electronically produced by a
linear accelerator, or superficial therapy machine.
This form of treatment is painless and it is similar
to having an x-ray taken. The type of cancer you
have and the part of your body that is affected
influences the choice of treatment machine.
Some machines are better at treating cancers close to the surface of
the skin, while others are used for treating cancers deep within the
body. Although the machines do different things, they are all basically
similar and apart from superficial X ray machines, they are large and
not transportable.
If you have never seen a treatment machine you may feel frightened
and concerned, but you will soon get used to its size. These
machines make loud humming noises when they are switched on
and move about. The machines move up, down and around you, so
that radiation can be directed at the cancer from different angles.
These machines are operated by trained staff called radiation
therapists and are checked by the medical physicist, who makes
sure the equipment is always working correctly.
It is normal to feel a bit anxious. However, you will feel more at ease
as you get to know the staff and procedures at the treatment centre.
Your first visit
At your first visit with the radiation oncologist your referral letter,
medical records, x-rays and other tests will be reviewed. In addition,
the radiation oncologist will talk to you about your general health
and possibly examine you. The radiation oncologist will then decide
if radiation therapy will help you, and if so what kind of radiation
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therapy is best for you. Other tests may be ordered to give the
radiation oncologist more information about your cancer. You will be
able to discuss this and any other questions you wish. It is helpful to
have a family member or friend at the consultation.
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What is planning?
Planning is an essential preparation for treatment
and usually involves one or two visits to the
treatment centre prior to treatment starting.
Planning involves having a CT scan or an x-ray
on which the radiation oncologist can mark the
precise location and size of the cancer. The x-ray
is taken by a special machine called a simulator.
Usually special devices may be used to ensure you are in the same
position each treatment. For instance, many treatments involving
the head and neck area a plastic mask called a shell is made.
This shell is worn during treatment and allows the markings to be
placed on the shell instead of the skin. Most people do not find it
uncomfortable while wearing the shell and you are still able to hear,
speak, and breathe normally. If there is any discomfort or anxiety
please tell the staff.
Once the treatment is prescribed, two to three very small permanent
marks (tattoos) may be placed on the skin (apart from the head and
neck area where the shell is marked). These marks are less than
the size of a freckle, and are too small to be seen easily. They are
made by placing a small amount of ink under your skin. These marks
ensure your treatment area is correctly located.
The type of cancer, the area being treated, your body’s response and
even your body size helps to decide how much radiation you will
receive and how it is given.
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During your planning, you will meet with the radiation therapist.
Radiation therapists are specially trained and work with the radiation
oncologists to plan and prepare your treatment. At the end of your
planning session a photo of your face will be taken. This is used for
identification purposes. Photographs of the part of your body being
treated will also be taken.
At your planning visit you will probably meet the radiation oncology
nurse whose special training enables him/her to help you throughout
treatment. He or she will tell you how to best look after yourself
during treatment and can answer questions you may have about the
treatment. Other health professionals such as the physiotherapist,
occupational therapist, speech pathologist, dietician, social worker
and/or welfare officer are also available to help.
What technologies are available?
Three dimensional conformal radiotherapy uses information from a CT
scan to tailor how the treatment is given. Additional information from
other types of scans, such as an MRI or PET, can be helpful to fuse
with the CT at this stage. Since tumours can sometimes move on a
day to day basis, such as with breathing, Image Guided Radiotherapy
(IGRT) allows more accurate targeting of some tumours. This can
involve further procedures such as placing a marker in the tumour.
A more focussed form of treatment called intensity modulated
radiotherapy (IMRT) can help reduce the amount of radiation received
by body parts near the tumour. For some tumours, this can reduce
the likelihood of side effects. Radiotherapy is a rapidly changing field,
so be sure to ask your Radiation Oncologist what treatments are
currently available, and are best for you.
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How long is a course of treatment?
The treatment length is tailored specifically for you. It depends on the
total dose needed to treat your cancer. Treatment varies from one
single dose to more than 35 doses. The term for radiation dosage is
the Gray. The total dose is divided into smaller daily doses known
as fractions. In order to reduce the effects of radiation therapy on
normal cells, treatment is generally planned so that small doses
are given daily over a set period of time. Treatments are usually
given once a day, Monday to Friday. This may mean a treatment
period of up to eight weeks depending upon the total dose needed.
Treatments are sometimes given only once or twice a week and very
occasionally they may be given more than once a day.
Will the treatment be painful?
Radiation therapy is not painful. The radiation therapist will take
you into the treatment room where you will be positioned on
the treatment table. The marks on your skin or on your shell will
be used as a guide. The table can be rather hard and if you are
uncomfortable, tell the radiation therapist.
You will be alone in the treatment room while the machine is
operating. The radiation therapist will be observing you via a TV
monitor. A microphone is also available. It is important to relax,
breathe normally and lie as still as possible. This ensures that the
treatment is accurate. The machine is only turned on after the
radiation therapist has made sure you are in the correct position.
The actual treatment usually takes a very short time, a few minutes at
most. Some pain may be felt in the treatment area towards the end
of therapy which results from damage to the normal tissues. You will
be given medication for this.
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Will I be radioactive?
External radiation therapy does not make you radioactive. It is safe
to be with your children, family and friends including anyone who
might be pregnant at home. This includes throughout the treatment
and after the treatment has been completed. If you have any
questions or concerns speak to your radiation oncologist, radiation
therapist or nurse.
Remember, it is very important to have
all your treatments in order to receive the
maximum benefit. If you are unable to
attend please notify the staff at the
treatment centre.
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For further information,
please feel free to call the
Cancer Council Helpline
on 13 11 20,
Monday to Friday,
between 8am and 6pm.
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Internal radiation
Internal radiation is given in two ways.
1) By placing radioactive sources (seeds or wires) inside
the body close to, or inside the cancer.
This is known as brachytherapy.
2) By using a radioactive liquid or capsule taken by mouth or radioactive liquid given by injection.
This is known as radioisotope therapy.
Internal radiation delivers radiation close to the tumour with the
radiation having to pass through only a short distance to reach the
cancer. This has the advantage of giving a high dose of radiation
directly to the cancer while limiting the dose to the surrounding
normal tissues.
Special precautions are taken while the radioactive sources are in
your body to avoid unnecessary radiation exposure to hospital staff
or your family and friends. Depending on the type of internal radiation
that is given, these precautions may last only a few minutes or up to
several days. Sometimes a hospital stay, usually only for a few days,
may also be needed.
Only a few hospitals in Queensland are able to deliver internal
radiation and the routines vary between these hospitals. The staff
involved in giving this treatment will see you and explain the details
more fully if this treatment is recommended.
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Brachytherapy
Brachytherapy involves placing radioactive sources into the body,
close to, or inside the cancer. Sources commonly used include
iridium, iodine or strontium. Applicators are used to place the
sources into the body and come in different shapes and sizes
depending on the type of cancer you have. Admission to hospital
may be necessary.
Brachytherapy can be used to treat a wide variety of cancers. Your
doctor may suggest treatment using brachytherapy alone or in
combination with external radiation.
How are the applicators placed into the body?
Many applicators can be inserted and removed on the same visit
and the treatment will only take a few minutes. The insertion of
other applicators may require admission to hospital. You may need
an anaesthetic while the doctor positions the applicators. Once the
applicator is in place, the position of the applicators may need to be
confirmed by taking an x-ray. When the applicators are confirmed to
be in a satisfactory position, the radioactive sources are then passed
into the applicator by a special machine that is connected to the
applicators by flexible tubes.
How long will the applicators be in my body?
The applicators may be left in place for a few minutes or left up
to several days. These treatments may be given as an outpatient
procedure, a day surgery procedure or may require you to
stay in hospital for a few days. This will depend on the type of
brachytherapy applicators and sources that are used.
Will brachytherapy be painful?
You may feel some discomfort but you should not experience severe
pain or feel ill when the applicators are in place. Once the applicator
is removed you may feel sensitive in the treatment area for some time.
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Will I be radioactive?
While the radioactive sources are in place some radiation may pass
outside your body. Once the radioactive sources are removed all
traces of radioactivity disappear. Depending on the type of treatment
given, you may need to be in a special isolated room in the hospital
for this treatment. There may be special precautions that have to
be taken by hospital staff and your visitors while you are having
this treatment. If you are required to swallow a radioactive liquid or
capsule, then you will be radioactive until all traces of the radioactive
source leave your body. The staff in the ward will inform you of any
special requirements prior to your admission to hospital and will
advise you of any special needs on your return home.
What are permanent seed implants?
In some cancers such as prostate cancer, the radioactive sources
may be left in place permanently. This is known as a permanent
seed implant. Small radioactive seeds are inserted into the prostate
gland and deliver small doses of radiation to the cancer slowly over
time. This radioactivity gradually fades away after about a year.
The type of radiation given by these radioactive seeds can only
penetrate a short distance within the prostate gland, so there is no
risk of radiation exposure to other people. You should discuss the
type of brachytherapy insertion you are to receive with your radiation
oncologist, radiation therapist or nurse.
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Radioisotope therapy
The most common radioisotope used is
radioactive iodine. This is used to treat cancer of
the thyroid. This is given as a liquid drink or as
a gelatine capsule to swallow. It is absorbed by
your body and taken up by your thyroid cells.
This treatment requires a short stay in hospital. During this time
you will be in a special isolation room while you are temporarily
radioactive. The radioactive iodine taken up by the thyroid cells
becomes less radioactive each day. Any radioactive iodine that is not
taken up by the thyroid cells is passed out of the body in the urine,
sweat or faeces. The amount of radiation that is in your body
is measured regularly during your hospital stay.
As the radiation level in your body decreases, it will reach a safe
level for you to be able to go home. There may be some special
precautions that you need to take for a short while after you are
home. You should discuss what to bring into hospital with you, and
also special care after discharge, with your radiation oncologist or
nurse.
Radioisotopes can be used to treat secondary bone cancer.
The radioisotope is injected into a vein and circulates to the area
of the cancer in the bone. This is a simple procedure and hospital
admission is generally not required.
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For further information,
please feel free to call the
Cancer Council Helpline
on 13 11 20,
Monday to Friday,
between 8am and 6pm.
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Side-effects from treatment
Radiation therapy affects normal cells in the area
close to the cancer, causing some expected and
localised side-effects. The nature of the sideeffects will depend on the type of cancer, the
amount of radiation given and most of all the
part of the body being treated.
Side-effects, if they do occur, usually appear after you have received
a few weeks of treatment. However, it is important to remember
that most people usually experience a few side-effects. The most
common side-effects of radiation therapy are tiredness, fatigue and
skin irritation.
If side-effects do occur, even though these are temporary, you need
to tell your Radiation Oncologist and nurse about them. Prescribed
medication may be used to reduce side-effects. Do not use any
home remedies, creams or medicines to relieve side-effects without
consulting your radiation oncologist or nurse. Side-effects will often
begin within two to three weeks of treatment starting. Side-effects
may persist for up to four weeks after completion of treatment and
will decrease over time while the damaged cells return to normal. It
is important you speak to your radiation oncologist or nurse about
follow up arrangements once treatment is finished. Most often you
will be advised to contact your local doctor if problems occur once
treatment is completed.
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What can I do about fatigue?
Fatigue (weariness or tiredness) is common for people receiving
radiation therapy. It occurs because your body is using a lot of
energy to rebuild normal cells. Fatigue commonly builds up over
the time of your treatment, especially if you have had either surgery
or chemotherapy. Fatigue may continue for a few months following
treatment. This will vary for each person. Signs of fatigue may
include feeling worn out, a heavy feeling in your arms and legs,
finding it hard to do your daily activities or to think clearly.
You may find the following tips helpful:
Rest or sleep for short periods during the day.
Stick to a routine of light, regular exercise such as short walks.
Keep activity or exercise for early in the day.
Spread out daily activities and if possible ask others to help with tasks.
Try new, quieter activities such as handicrafts, relaxation techniques
or reading.
If you are not sleeping well at night, discuss this with your doctor
or nurse. If you have a job, it may be possible to take a few weeks
off work, to reduce your hours while you are having treatment.
Many people benefit from a holiday from their work and other
responsibilities after completing radiation therapy, as this is when any
side-effects and tiredness tend to be at their worst. If you have any
questions or concerns speak to your radiation oncologist, radiation
therapist or nurse.
Remember, your energy will return as your
body recovers from treatment.
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Skin problems
The effects of radiation are cumulative and any reactions will
continue for 10-14 days after treatment is finished. Sometimes the
reaction will get worse after treatment, before it gets better.
Some people develop a skin reaction while having treatment,
however the extent of the reaction depends upon the individual
person, their skin colouring and the area being treated. Sometimes
the skin on the area being treated may begin to look reddened and
irritated, resembling sunburn. This is normal and usually clears up
within days following completion of your treatment.
Wear soft loose clothing. Do not wear restrictive, tight fitting clothing,
collars or belts over the part of your body being treated.
Do not scrub or scratch the treated area. If you do need to wash the treated
area do not rub with a towel when drying the area.
Ask your radiation oncologist or nurse before you use soap, perfume,
deodorant, talcum powder, creams or cosmetics on the treatment area,
especially those that contain alcohol or metals. If required, a special
moisturiser may be prescribed from the hospital.
Do not put hot water bottles, heat packs or ice packs on the treated area.
If you need to shave the area being treated, use an electric razor only. If you
are having any part of your face treated, do not use aftershave lotion.
Your skin may also be more sensitive than usual to the sun. Try to
keep treated areas out of the sun during and after treatment. Ask
your radiation oncologist, radiation therapist or nurse about whether
you can use a sunscreen on treated areas.
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Normal cells in the area of your body being treated are affected by
radiation therapy. Remember that any additional side-effects that
occur due to radiotherapy will be localised to the area of the body
being treated. Your radiation oncologist and nurse will discuss the
side-effects from your particular treatment.
Based on the part of the body being treated, common side-effects
may include the following.
If the head is treated:
•hair loss.
•headaches or ear-ache.
If the neck and mouth is treated:
•voice and taste changes.
•swallowing difficulties.
•dry mouth.
•mouth ulcers.
If the trunk of the body, chest and breast is treated:
•swallowing difficulties.
•pain in the gullet.
•reflux.
•swelling in arm(s).
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If the abdomen, pelvis or buttocks is treated:
•nausea.
•vomiting.
•diarrhoea.
•bladder symptoms.
•pain in the rectum.
•constipation.
•changes in sexual function and fertility.
•swelling in the leg(s).
If you are experiencing side-effects from radiation therapy please
discuss these with your radiation oncologist, radiation therapist
or nurse. Usually simple procedures and information will help
you to manage the effects of treatment. It is possible that you
may be referred to health professionals who will provide you
with information about coping with the symptoms of cancer or
side-effects of treatment. These may include a dietician, speech
pathologist, physiotherapist, occupational therapist, sex therapist or
psychologist.
Additional booklets are also available about the side-effects of
cancer and cancer treatments. These include appetite, hair loss,
lymphodema, emotions and changes to sexual function.
For further information about your cancer,
treatment side-effects or for a referral to
a health professional contact the Cancer
Council Helpline on 13 11 20.
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Getting to and from treatments
While treatment schedules may vary for
individuals, you may spend some time travelling
to your treatment.
Since radiation therapy is usually given on an outpatient basis, you
will need to arrange for transportation. If you’re not feeling well, you
may want to arrange for a family member, friend or neighbour to
drive. If you live in rural Queensland, you may be away from home for
an extended period of time.
Often financial assistance is provided for travel and accommodation
through the Queensland Government’s Patient Travel Subsidy
Scheme. To check your eligibility or to make an application, contact
a social worker or means test clerk at your nearest public hospital.
If you are visiting Brisbane or Townsville for your treatment,
information booklets on these areas are available by contacting the
Cancer Council Helpline on 13 11 20 Monday to Friday, 8am to 6pm.
For details about accommodation facilities nearest to your hospital
and transport services, contact the welfare officer or nurse at your
treatment hospital, or contact the Cancer Council Helpline on
13 11 20.
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Check-ups and follow-up care
No matter what type of cancer or treatment you
have had, you will need regular check-ups. After
your treatment has finished you will be advised
when and where you should have follow-up
visits.
You will usually be asked to return to the radiation oncologist for
one or more visits. The radiation oncologist will want to check the
effectiveness of the treatment and assess any problems you may be
having.
How often you have these check-ups will vary from one hospital to
another, but as you progress, check-ups will become less frequent.
The doctor who referred you to the radiation oncologist will receive a
complete report on your treatment and will discuss it with you when
you visit. If you develop any problems in between your check-up
appointments, do not hesitate to contact your treatment centre or
your doctor.
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These are some practical tips that will help make
life easier during treatment:
1) Sometimes during radiation therapy you may have to wait at the
treatment centre for your treatment. Some people bring a book,
crossword puzzle, needlework or other craft to help the time pass
more pleasantly.
2) Wear as little clothing as is sensibly possible when you go for your
treatments. This will cut down your changing time. In addition,
wear clothing that is easy and comfortable to get on and off.
3) Think about asking a friend or a member of your family for help to
do your shopping.
4) Plan easy-to-cook meals which can be prepared in advance.
5) You may be able to get someone to come in on a regular basis
to assist with the laundry and other household chores. There are
many agencies which offer help of this kind. Check with your
hospital social worker or welfare worker or contact the Cancer
Council Helpline on 13 11 20.
6) You may also need some help in caring for young children.
Investigate the childcare centres and day-care groups in your
area, and discuss your needs with nearby relatives and friends
who may be able to help.
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For further information,
please feel free to call the
Cancer Council Helpline
on 13 11 20,
Monday to Friday,
between 8am and 6pm.
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Coping with cancer
“There is a fear that goes through you when
you are told you have cancer. It’s so hard in
the beginning to think about anything but your
diagnosis. It’s the first thing you think about
every morning. I want people diagnosed with
cancer to know it does get better. Talking about
your cancer helps you deal with all of the new
emotions you are feeling. Remember, it’s normal
to get upset.”
— Katrina, cancer survivor
When you are told you have cancer, the diagnosis affects not only
you, but also your family and friends. You may feel scared, uncertain,
or angry about the unwanted changes cancer will bring to your life
and theirs. You may feel numb or confused. You may have trouble
listening to, understanding, or remembering what people tell you
during this time. This is especially true when your doctor first tells
you that you have cancer. It is common for people to shut down once
they hear the word “cancer.”
There is nothing fair about cancer and no one “deserves” to have
it. A cancer diagnosis is hard to take and having cancer is not easy.
Accepting the diagnosis and figuring out how cancer fits into your
life is challenging. The good news is that more than 60 per cent of
cancer patients will survive more than five years after diagnosis.
For those diagnosed with advanced disease there are many
treatments and services to assist you to live a good quality life while
living with cancer.
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After you are diagnosed with cancer, you may feel shock, disbelief,
fear, anxiety, guilt, sadness, grief, depressed, and anger. Each person
may have some or all of these feelings, and each will handle them in
a different way.
There are many resources and people to help you through this phase
of your life and you do not need to go through this on your own. The
following tips for managing come from those who have survived the
cancer journey themselves.
•Gather information about your cancer diagnosis and
treatment so that you are informed about your body,
your treatment and potential treatment side-effects.
Knowledge can help lessen the fear of the unknown.
•Be your own advocate. Even though people facing
cancer cannot change their diagnosis, they can seek
out reliable, up-to-date information and talk to family
members, friends, and their health care team. Finding
good sources of support can help people with cancer
take control of their situation and make informed
decisions.
•Bring a family member or friend along to appointments.
They can serve as an extra pair of ears, help you
remember things later, and give you support.
•Ask for support from family, friends, and others. Just
having someone who cares and will listen to you can
be very helpful. If friends or family members are not
able to be supportive, find others who will. Health care
professionals (such as social workers, psychologists, or
other licensed health professionals) and support groups
can be extra sources of support.
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•Pay attention to your physical needs for rest, nutrition,
and other self-care measures.
•Find out what helped other patients and families
manage their cancer, and/or talk with other people
diagnosed with the same type of cancer.
•Take one day at a time.
Cancer Council Queensland has a range of support services
available to those affected by cancer. If you are seeking information,
support, guidance or practical assistance make the call and speak
to a trained health professional who can respond to your query while
providing support.
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Talking to your doctor
Getting all the facts about your cancer and
its treatment helps you to feel more in control.
Here are some tips for communicating with
your doctor.
•Talk with your doctor as often as necessary.
•Take someone with you to your doctor’s
appointments. Have a family member or a friend with
you, so that they can ask questions, write down the
answers and help you keep the information straight.
•Don’t be afraid to ask. If you have questions of a
confidential nature about any aspect of your treatment,
don’t hesitate to ask your doctor. For example, you
may have questions about the cost of medications
and treatment. If your doctor cannot answer these
questions, ask to be referred to someone who can.
•Don’t be afraid to interrupt. Stop the doctor to
ask about technical terms or statements you don’t
understand.
•Write it down. You’ll feel more confident of what you
know if you have it in writing. Urge the doctor to make
notes for you (if you can’t read the doctor’s handwriting,
let the doctor know).
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•Take your time. Whenever possible, talk with your
doctor when you both have enough time. If your doctor
doesn’t have time to sit down and really explain things,
suggest an appointment at a specific time when you, a
friend or family member and the doctor can talk at length.
•Where to start. If you’re not sure what to ask or how
much information you need, start by getting your
general practitioner’s help, for example: “If you were me,
what would you ask?”
The Cancer Council Helpline may also be able to assist.
Call 13 11 20 Monday to Friday, 8am to 6pm.
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How will treatment affect me
emotionally?
It is important for you, your family, and your
friends to be aware you may feel different during
the course of your radiation treatment.
Some people report feeling down or nervous. This may be due to
the fact your daily life schedule has been changed, because you
are tired, or because of your feelings about the cancer. It is not
unexpected or unnatural to feel this way. However, your attitude, your
mental and emotional approach to your treatments and to cancer
itself, is vitally important.
Some people have found relaxation exercises make them feel better.
You may want to ask your nurse, physiotherapist or occupational
therapist about ways to relax such as yoga, meditation or other
relaxation exercises. Cancer Council Queensland’s booklet or CD
on relaxation is available free by contacting the Cancer Council
Helpline on 13 11 20 Monday to Friday, 8am to 6pm. There are
also books and short courses available on these subjects.
It may help to talk to someone you feel comfortable with such as a
doctor, nurse, social worker, chaplain or family and friends. Cancer
Council Queensland’s booklet ‘Coping with Cancer’ may be helpful
to you. It provides information about personal and family reactions.
Ask your nurse, social worker or welfare officer about this booklet
or about support and information programs that are available, or
contact the Cancer Council Helpline on 13 11 20. Your social
worker or psychologist can also provide support for the many issues
that may affect you and your family during treatment. These health
professionals have specialised knowledge and experience in the
emotional and social aspects of cancer.
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For further information,
please feel free to call the
Cancer Council Helpline
on 13 11 20,
Monday to Friday,
between 8am and 6pm.
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Ways to help yourself
It is important to try and live as normal a life as
possible. Do the things you normally do and
maintain reasonable physical fitness and activity
within your ability.
•It is important you maintain a good, varied diet. Keep up
fluids (at least two litres a day). This helps the body get
rid of unwanted cells during treatment and is especially
important in the Queensland summer. Carry a water
bottle at all times.
•Assist your health team by keeping your appointments.
If you are unwell, or think you are unable to attend
an appointment, contact the health team as early as
possible. Try to have blood and other tests ordered at
the requested time. This may save you waiting longer for
results.
•Tell your doctor and pharmacist about any other
medication, pills or drugs that you are taking.
•You may find it helpful to try relaxation or meditation
techniques that can help you cope with side-effects and
feel more in control. The techniques can help you lower
any anxiety you may be feeling and help you approach
treatment with a more relaxed and positive attitude. The
physiotherapist and/or occupational therapist at your
hospital or local community health centre may be able
to assist you with this.
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•Some people find it helpful to set short-term goals while
having treatment. This helps break down the treatment
path into achievable steps and gives you a sense of
moving forward.
Many support services are available. The health care team in the
hospital where you are receiving treatment have a number of support
staff who can assist you in many ways. There is also a range of
community based services, support groups and support programs
available to assist you.
Contact your nearest Cancer Council Queensland office or
our Helpline on 13 11 20 Monday to Friday, 8am to 6pm for
information, personal and family support and practical assistance.
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For further information,
please feel free to call the
Cancer Council Helpline
on 13 11 20,
Monday to Friday,
between 8am and 6pm.
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About clinical trials
During your treatment you may be asked to
participate in clinical trials. Clinical trials are
research studies which attempt to find better
ways to prevent, diagnose and treat cancer.
Clinical trials test many types of new treatments such as new cancer
drugs, new approaches to radiation therapy or surgery or new
methods of treatment such as cancer vaccines or immunotherapy.
A clinical trial is one of the final stages of a long and careful cancer
research process. The search for new treatments begins in the
laboratory where scientists first develop and test new ideas. To reach
the clinical trial stage, there has been a lengthy series of scientific
experiments and promising evidence of effectiveness before the
treatment can be given to people with cancer. Thus, the clinical trial
represents the careful progression from the laboratory experiments
to the establishment of a treatment option for cancer, and is an
essential step in the development of improved treatments for cancer.
If you are invited to participate in a clinical trial, be sure to get
complete information from your doctor so you can make an informed
decision. You do not have to take part in a clinical trial if you do not
want to, it is your choice.
If you would like to know if you are eligible for a clinical trial, ask
your radiation oncologist or local doctor. If you would like more
information about the selection procedures for clinical trials, call the
Cancer Council Queensland’s Helpline on 13 11 20 for a copy
of the booklet ‘Understanding Clinical Trials’.
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Notes
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Notes
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Notes
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Notes
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For information and support call
Monday to Friday, 8am - 6pm
www.cancerqld.org.au
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